Comparative evaluation of mineral trioxide aggregate, diode and erbium, chromium-doped yttrium, scandium, gallium, and garnet laser-assisted mineral trioxide aggregate pulpotomy in primary molars - A randomized controlled trial.

OBJECTIVES: The success of pulpotomy depends on the medicament or technique used to preserve the vitality of the remaining radicular pulp. With the advent of bioactive materials and laser technology, newer modalities have been introduced to improve treatment outcomes. This randomized controlled trial clinically and radiographically compared pulpotomy using mineral trioxide aggregate (MTA), diode and erbium, chromium-doped yttrium, scandium, gallium, and garnet (Er, Cr: YSGG) laser-assisted MTA in primary molars. MATERIALS AND METHODS: Thirty-six children aged 5-8 years were randomly allocated into three groups ( n = 12 each): Group I- MTA pulpotomy, Group II- diode laser-assisted MTA pulpotomy, and Group III- Er, Cr: YSGG laser-assisted MTA pulpotomy. Clinical parameters (pain, swelling, mobility, sinus tract, and tenderness on percussion) and radiographic parameters (inter-radicular radiolucency, integrity of lamina dura, and pathological root resorption) were assessed at baseline and at 3-, 6-, and 9-month follow-ups. Statistical analysis included the Shapiro-Wilk test, one-way analysis of variance (ANOVA), repeated-measures ANOVA, Kruskal-Wallis test, and Friedman test, with significance set at P < 0.05. RESULTS: All three groups demonstrated high clinical and radiographic success throughout the 9-month follow-up period. No statistically significant intergroup differences were observed. At 9 months, clinical success was 75% for MTA, 100% for Er, Cr: YSGG laser, and 91.7% for diode laser, while radiographic success was 100%, 100%, and 91.7%, respectively. The numerical differences did not reach statistical significance. CONCLUSION: MTA, diode laser, and Er, Cr: YSGG laser pulpotomy produced comparable clinical and radiographic outcomes in primary molars. Laser-assisted pulpotomy represents an effective alternative to conventional medicament-based vital pulp therapy.